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目的探讨子宫肌瘤的MR表现及MRI对高强度聚焦超声(HIFU)治疗后的评价价值。方法回顾性分析我院36例共54个肌瘤在HIFU治疗前及治疗后1、3、6月行MRI平扫、增强资料,对比治疗前后肌瘤的MRI信号、体积及强化程度变化。结果HIFU术后1月,38个肌瘤为稍短T1WI短T2WI信号,7个为等T1WI稍长/短混杂T2WI信号,9个为稍短/长T1WI短T2WI信号。术后3个月及6个月,7个肌瘤T2WI信号进一步降低且坏死范围有所扩大,余47个肌瘤信号与1月相比无明显变化。增强扫描47个肌瘤无明显强化,7个术后以稍长T2WI为主混杂信号的肌瘤轻度不均匀强化,正常子宫肌层强化与术前相比无明显变化。54个肌瘤HIFU术前平均体积为57.2cm3,术后6个月平均体积为50.9cm3,体积总缩小率为11%(t=2.56,P>0.05),差异无显著意义。结论MRI能有效观察子宫肌瘤HIFU治疗前后信号、血供和大小改变,是HIFU术后随访及疗效评价的有效手段。
Objective To investigate the MR findings of uterine fibroids and MRI evaluation of high intensity focused ultrasound (HIFU). Methods Retrospective analysis of 36 cases of fibroids in our hospital in 54 cases of HIFU before and after treatment, 1, 3, 6 months after MRI plain scan to enhance the data, compared before and after treatment of fibroids MRI signal volume and degree of enhancement changes. Results One month after HIFU, 38 fibroids were short T1WI short T2WI signals, 7 were T1WI slightly longer / shorter hybrid T2WI signals and 9 were short / long T1WI short T2WI signals. At 3 months and 6 months after operation, the T2WI signal of 7 fibroids was further reduced and the necrosis range was expanded. There was no significant change in the signal of the other 47 fibroids compared with January. Forty-seven myomas with contrast-enhanced scanning showed no significant enhancement, and 7 myofibers with slightly longer T2WI-dominated mixed signals had slight uneven enhancement. There was no significant difference between normal myometrium and normal myometrium. The average preoperative volume of HIFU in 54 myoblasts was 57.2 cm3, the average volume was 50.9 cm3 at 6 months and the total volume reduction rate was 11% (t = 2.56, P> 0.05). There was no significant difference between the two groups. Conclusion MRI can effectively observe the changes of signal, blood supply and size before and after treatment of HIFU in uterine fibroids, which is an effective means for follow-up and evaluation of the curative effect of HIFU.